All I'm saying is let's take the example of something like diabetes, one of --- a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family -- if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money.

Up to $50,000 per amputation? Reimbursed immediately? I saw an excellent comment on a post at Little Miss Attila.com that kindly did the math for me:

Letís not forget the $50,000 a surgeon gets for amputating a limb. Assuming a fairly light workload, say, five such procedures a day five days a week with two weeks of vacation a year, then such a surgeon could earn over $62,000,000 a year.

Woo hoo! I immediately asked Gary, "Where have you been hiding that $62,000,000 that you make every year?" I said that I understood that this was based on taking only two weeks of vacation, and that I was OK with him taking his full five weeks even if it was costing us almost $4,000,000. Ya know, the guy works hard in the abattoir, oops, I mean hospital, hacking off limbs and tonsils right and left. Which reminds me, I'm not sure how much the President said doctors were getting for all the unnecessary tonsillectomies that they are doing, but I have to figure that Gary should stick with the limb amputations.

Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.

*sigh*

I guess we'll have to keep working a while longer after all. And in the interest of full disclosure, I need to point out that Gary actually does do amputations. In fact he did one six weeks ago on a man who had been hit by a cab outside the Kimmel Center. They had to amputate one leg, but were able to save the other one. The guy has been doing well, learning to walk on his new prothesis and was being transferred to a rehabilitation center this week. When Gary picked me up from work on Wednesday there was a t-shirt on the back seat. He went to say goodbye to his patient and the man told all of the folks in the room, "this is the doc that saved my life," and gave him one of the t-shirts that his buddies had printed up for a fund-raiser.

Funny, he didn't seem to think that Gary was one of the money-grabbing vampires that some other people are painting doctors out to be.

Quote du jour:

"Every violation of truth is not only a sort of suicide in the liar, but is a stab at the health of human society."